Yves here. This post points out that some of Trump’s picks in key positions under RFK, Jr. hold views at odds with the prospective Secretary. One unwittingly revealing comment is how often RFK, Jr’s subordinates will have to explains what a confidence interval is. The confidence interval is generally not well understood among people who have taken statistics courses. IM Doc, who has taught statistics, has said more than once that statistical knowledge among health professionals generally is poor.
Also note the New England Journal of Medicine finding that the efficacy of the Covid vaccines against infection at four weeks is 52%. That is not an impressive figure.
By Stephanie Armour, KFF Health News senior health policy correspondent, who previously worked at The Wall Street Journal, Bloomberg, USA Today, The Des Moines Register, and the Daily Tribune in Ames, Iowa and Julie Rovner, KFF Health News chief Washington correspondent, who worked previously for NPR, National Journal’s Congress Daily and Congressional Quarterly, among other organizations. Originally published at KFF Health News
Many of President-elect Donald Trump’s candidates for federal health agencies have promoted policies and goals that put them at odds with one another or with Trump’s choice to run the Department of Health and Human Services, Robert F. Kennedy Jr., setting the stage for internal friction over public health initiatives.
The picks hold different views on matters such as limits on abortion, the safety of childhood vaccines, the covid-19 response, and the use of weight-loss medications. The divide pits Trump picks who adhere to more traditional and orthodox science, such as the long-held, scientifically supported findings that vaccines are safe, against often unsubstantiated views advanced by Kennedy and other selections who have claimed vaccines are linked with autism.
The Trump transition team and the designated nominees mentioned in this article did not respond to requests for comment.
It’s a potential “team of opponents” at the government’s health agencies, said Michael Cannon, director of health policy studies at the Cato Institute, a libertarian policy organization.
Kennedy, he said, is known for rejecting opposing views when confronted with science.
“The heads of the FDA and NIH will be spending all their time explaining to their boss what a confidence interval is,” Cannon said, referring to a statistical term used in medical studies.
Those whose views prevail will have significant power in shaping policy, from who is appointed to sit on federal vaccine advisory committees to federal authorization for covid vaccines to restrictions on abortion medications. If confirmed as HHS secretary, Kennedy is expected to set much of the agenda.
“If President Trump’s nomination of RFK Jr. to be secretary is confirmed, if you don’t subscribe to his views, it will be very hard to rise in that department,” said Amesh Adalja, an infectious disease specialist and senior scholar at the Johns Hopkins Center for Health Security. “They will need to suppress their views to fit with RFK Jr’s. In this administration, and any administration, independent public disagreement isn’t welcome.”
Kennedy is chair of Children’s Health Defense, an anti-vaccine nonprofit. He has vowed to curb the country’s appetite for ultra-processed food and its incidence of chronic disease. He helped select Trump’s choices to lead the Centers for Disease Control and Prevention, the Food and Drug Administration, and the National Institutes of Health. If confirmed, he would lead them from the helm of HHS, with its more than $1.7 trillion budget.
Clashes are likely. Kennedy has supported access to abortion until a fetus is viable. That puts him at odds with Dave Weldon, the former Florida congressman whom Trump has chosen to run the CDC. Weldon, a physician, is an abortion opponent who wrote one of the major laws allowing health professionals to opt out of participating in the procedure.
Weldon would head an agency that’s been in the crosshairs of conservatives since the covid pandemic began. He has touted his “100% pro-life voting record” on his campaign website. (He unsuccessfully ran earlier this year for a seat in Florida’s House of Representatives.)
Trump has said he would leave decisions about abortion to the states, but the CDC under Weldon could, for example, fund studies on abortion risks. The agency could require states to provide information about abortions performed within their borders to the federal government or risk the loss of federal funds.
Weldon, like Kennedy, has questioned the safety of vaccines and has said he believes they can cause autism. That’s at odds with the views of Marty Makary, a Johns Hopkins surgeon whom Trump plans to nominate for FDA commissioner. The British American said on the “Brian Kilmeade Show” on Fox News Radio that vaccines “save lives,” although he added that it’s good to question the U.S. vaccine schedule for children.
The American Academy of Pediatricians encourages parents and their children’s doctors to stick to the recommended schedule of childhood vaccines. “Nonstandard schedules that spread out vaccines or start when a child is older put entire communities at risk of serious illnesses, including infants and young children,” the group says in guidance for its members.
Jay Bhattacharya, a doctor and economist who is Trump’s selection to lead NIH, has also supported vaccines.
Kennedy has said on NPR that federal authorities under his leadership wouldn’t “take vaccines away from anybody.” But the FDA oversees approval of vaccines, and, under his leadership, the agency could put vaccine skeptics on advisory panels or could make changes to a program that largely protects vaccine makers from consumer injury lawsuits.
“I do believe that autism does come from vaccines,” Kennedy said in 2023 on Fox News. Many scientific studies have discredited the claim that vaccines cause autism.
Ashish Jha, a doctor who served as the White House covid response coordinator from 2022 to 2023, noted that Bhattacharya and Makary have had long and distinguished careers in medicine and research and would bring decades of experience to these top jobs. But, he said, it “is going to be a lot more difficult than they think” to stand up for their views in the new administration.
It’s hard “to do things that displease your boss, and if [Kennedy] gets confirmed, he will be their boss,” Jha said. “They have their work cut out for them if they’re going to stand up for their opinions on science. If they don’t, it will just demoralize the staff.”
Most of Trump’s picks share the view that federal health agencies bungled the pandemic response, a stance that resonated with many of the president-elect’s voters and supporters — even though Trump led that response until Joe Biden took office in 2021.
Kennedy said in a 2021 Louisiana House oversight meeting that the covid vaccine was the “deadliest” ever made. He has cited no evidence to back the claim.
Federal health officials say the vaccines have saved millions of lives around the globe and offer important protection against covid. Protection lasts even though their effectiveness wanes over time.
The vaccines’ effectiveness against infection stood at 52% after four weeks, according to a May study in The New England Journal of Medicine, and their effectiveness against hospitalization was about 67% after four weeks. The vaccines were produced through Operation Warp Speed, a public-private partnership Trump launched in his first term to fast-track the shots as well as other treatments.
Makary criticized covid vaccine guidance that called for giving young children the shots. He argued that, for many people, natural immunity from infections could substitute for the vaccine. Bhattacharya opposed measures used to curb the spread of covid in 2020 and advised that everyone except the most vulnerable go about their lives as usual. The World Health Organization warned that such an approach would overwhelm hospitals.
Mehmet Oz, Trump’s choice to head the Centers for Medicare & Medicaid Services, an agency within HHS, has said the vaccines were oversold. He promoted the use of the anti-malaria drug hydroxychloroquine as a treatment. The FDA in 2020 revoked emergency authorization of hydroxychloroquine for covid, saying that it was unlikely to be effective against the virus and that the risk of dangerous side effects was too high.
Janette Nesheiwat, meanwhile, a former Fox News contributor and Trump’s pick for surgeon general, has taken a different stance. The doctor described covid vaccines as a gift from God in a Fox News opinion piece.
Kennedy’s qualms about vaccines are likely to be a central issue early in the administration. He has said he wants federal health agencies to shift their focus from preparing for and combating infectious disease to addressing chronic disease.
The shifting focus and questioning of vaccines concern some public health leaders amid the spread of the H5N1 bird flu virus among dairy cattle. There have been 60 human infections reported in the U.S. this year, all but two of them linked to exposure to cattle or poultry.
“Early on, they’re going to have to have a discussion about vaccinating people and animals” against bird flu, said Georges C. Benjamin, executive director of the American Public Health Association. “We all bring opinions to the table. A department’s cohesive policy is driven by the secretary.”
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No wonder there is no comment yet!!!!!! Complicated is the word already!
To compare vaccines in general, which have had a huge beneficial effect for decades or longer, with the made-for-profit mRNA covid products, seems to be a big mistake! Just saying!
Exactly. The Covid shots effectiveness is similar to & probably less than the flu shots. They are somewhat effective at moderating the symptoms of the disease & may confer some immunity, but the rapid mutation rates, much greater than the flu, mean that repeated shots are needed throughout the year.
They were misrepresented as safe, effective & sterilizing as in “get the shot & & let’s see your smile.” This led to people letting down their guard & resuming normal behavior, which had the effect of actually amplifying the magnitude of the pandemic & resulted in the wave after wave of new variants, leaving us in our current situation.
Shorter this article: let’s not confuse the public by suggesting that the health care establishment might not have all the answers or be conflicted in their goals. Dangerous ideas must be suppressed. Ominiscence is our most important product.
Which to some of us sounds like the most dangerous idea of all. Here’s suggesting the Federal government should not be handing down health care guidance at all if it’s going to become so political.
Im willing to bet Kennedy knows exactly what a confidence interval is. Like him or not, as a lawyer he spent decades in litigation in cases involving scientific research.
It’s apparent Kennedy (and likely Tulsi) is not long for Washington. The antibodies of the systems are already hard at work as we see.
The discussion of vaccines is presented in black-and-white terms, as if all vaccines are the same and all are equally safe, and so “vaccines” are either “good” or “bad” but cannot have elements of both. Everyone knows that even the best vaccines sometimes have side effects; the question is whether they have all been accounted for when approvals are given.
Is this strictly a construction of the media [which does it all the time in political coverage], or was it first taken up by the PMC medical establishment, as in, “How dare you question our proclamation that all vaccines are safe?”
Also the idea that this will be the first Administration where you have to agree with the boss in order to get ahead is priceless. In the present Administration, anyone with concerns about vaccine safety was likely to get censored.
A sadly important health problem that has emerged, needing focused attention:
https://fred.stlouisfed.org/graph/?g=16TO1
January 4, 2020
Labor Force men and women with a disability, * 2017-2024
* Age 16 to 64
(Indexed to 2017)
https://fred.stlouisfed.org/graph/?g=16TwF
January 4, 2020
Labor Force with a disability, * 2017-2024
* Age 16 and over
(Indexed to 2017)
Hmmm, look at that uptick starting around 2020. Tis a mystery!
Thanks CA
“efficacy of the Covid vaccines against infection at four weeks is 52%”.
The intent of vaccines is to prevent serious illness and death, not infection, so the statement above doesn’t mean much.
Consider that inorder for your immune system to interact with an infection it has to be exposed to it at which point your are infected.
To create a vaccine that prevents infection is nearly impossible. Preventing symptomatic disease is more achievable and this maybe what they are refering to in the above state.
First, that was a clinical endpoint for Covid vaccines in other countries, such as China. Their clinical trials tracked infection as well as severe illness and deaths.
Second, the ONLY defensible justification for requiring Covid vaccinations was preventing/reducing contagion. If you got Covid, you can spread it, as Rochelle Walenksy found out in Provincetown in summer 2021, when the vaccinated has the same nasal viral load as the vaccinated.
Third, the vaccines were sold as preventing infection (both Biden and Walensky explicitly said so) and policies like restaurant bans for the unvaccinated were consistent with that belief.
Fourth, one month after vaccination as the measurement time looks like a sick joke, as in cherry picked to produce the best results. None of the studies looked at infection rates in the first two weeks after vaccination, based on the view that immunity was building up during that time. Immunity to the common cold is about six months. It would seem reasonable to expect the Covid vaccines to provide protection that long. The bizarre report for one month suggests the reverse.
Indeed that was the messaging at the time.
But as in any noval dynamic decision making event, mistakes were made, we shouldn’t be suprised by that.
It appeared the initial response to the vaccine was for it to be highly effective as you suggest, but unfortunately the unstable reproductive nature of the SAVS-COV virus increased it’s fitness and allowed it to evade our antibody response , which is what was giving the illusion of preventing infection.
Fortunately the T cell and B cell response offed by the vaccine did continue to provide an incredible effective defense against the virus. And this inarguably keep a very high percentage of vaccinated people out of the hospital and morgue. Saving the health cares system in a large number of regions from collapse.
Focusing solely on the ineffectiveness of the initial hope that this vaccine would prevent infection and not recognize the massive number of lives saved by it is a mistake, in my opinion.
mask and relax
I just did a brief search and it appears the term “against infection” is used to mean either “against symptomatic infection” or “against positive test.” I did not see any examples of it being used to mean “against entry of a viral particle into the system,” which would be ridiculous as you point out.
When you said . . . ” To create a vaccine that prevents infection is nearly impossible.” . . . did you mean to referrence Covid specifically in particular?
I understand that that applies to all vaccines. I have seen some argue that the HPV vaccine can prevent infection, but I have to leave that to specialists to fight out.
Remember the primary function of vaccines is to prevent serious illness, hospitalization and death.
Trump seems to think that building teams with differing views can lead to longer-term consensus on contentious issues – he does it repeatedly. Why put a team together of the like-minded when the next administration could replace them with opponents?
Can’t believe these articles ignore Kennedy’s complaints about the get-out-of-liability-free cards given to vaccine makers in the 1980s. Take those away and he believes the vaccines (as originally defined) will be more efficacious and safer. Marginal non-sterilizing products like the mRNA shots won’t make the cut. Autism and problems with specific vaccines are just a distraction from the liability issue and Pharma’s ability to redefine liability-free “vaccine” to apply to a far greater range of products.
Thanks Greg my thinking also. Start the dialogue and see what ideas and reporting get to the public. The back biting and gas lighting is all bait and switch to me.